Group Prenatal Care and Emergency Room Utilization

Pregnancy-related complaints are a significant driver of emergency room (ER) utilization among women. Because of additional time for patient education and provider relationships, group prenatal care may reduce ER visits among pregnant women by helping them identify appropriate care settings, improving understanding of common pregnancy discomforts, and reducing risky health behaviors. We conducted a retrospective cohort study, utilizing Medicaid claims and birth certificate data from a statewide expansion of group care, to compare ER utilization between pregnant women participating in group prenatal care and individual prenatal care. Using propensity score matching methods, we found that group care was associated with a significant reduction in the likelihood of having any ER utilization (–5.9% among women receiving any group care and –6.0% among women attending at least five group care sessions). These findings suggest that group care may reduce ER utilization among pregnant women and encourage appropriate health care utilization during pregnancy.

Feeling Better: Experiences and Needs of Adolescents and Professionals Regarding Their Mentoring Relationship in Residential Youth Care

Background In residential youth care, group care workers and teachers often serve as a mentor for individual adolescents. Although favorable mentoring relationships are associated with positive adolescent outcomes, few studies examined the role of mentoring in residential youth care. Objective The present study aims to assess adolescents’, care workers’ and teachers’ mentoring relationship needs in terms of their one-on-one conversations during residential care. Methods We conducted structured interviews with eleven adolescents, ten group care workers and two teachers and content analysis to assess the data Results All respondents are rather satisfied with their conversations, which are often concerned with how the adolescent is doing. Adolescents mostly consider their family and home-situation as difficult topics, while care workers mostly consider sexuality as a difficult topic to talk about. Although ‘improvement’ with the youth is often the aim, most adolescents report that they do not (know if they) show changes because of these conversations. Moreover, only one of the twelve professionals thinks that it is his core task to achieve behavior change with the adolescents. According to the professionals, conversations often aim at building a good relationship, coaching, determining treatment goals, and gaining insight into the adolescent. Adolescents prefer a mentor who is calm, has respect, listens, and is reluctant in giving advice. Most professionals do not use a specific method and doubt whether they want to have conversations according to a manual or support tool. Conclusions Despite being rather satisfied, adolescents and professionals indicate several points for improvement of one-on-one conversations.

Effects of March of Dimes Supportive Pregnancy Care on Social Support and Postpartum Depression

Purpose Group prenatal care, which integrates medical care with patient education and empowerment in a group setting, has the potential to build social support among pregnant women and reduce the risk of postpartum depression (PPD). Past research on group care’s effects on social support or PPD has produced inconsistent findings. Studies have tended to (1) examine direct effects on social support or PPD and (2) treat group care participation as a dichotomous variable. This study tests the hypothesis that group care has an indirect effect on PPD through its effect on social support. It uses both a dichotomous measure of group care participation and an ordinal measure of social contact with group members. Method This study used survey data from 199 women at two Tennessee health care sites who participated in traditional care (TC) or Supportive Pregnancy Care (SPC), a new group program developed by March of Dimes. Path analysis was employed, estimating standardized path coefficients with propensity score weighted multilevel modeling. Results The study found no evidence of an indirect relationship between SPC and PPD symptoms when modeling the dichotomous measure. Modeling the ordinal measure revealed more favorable PPD outcomes among women reporting high group member contact (compared with TC) and adverse outcomes among women reporting low group member contact. Conclusion SPC may be useful for preventing PPD symptoms among women socially engaged with other group care patients. Given the adverse effect among women who do not engage with other group members, group facilitators should encourage women to interact outside of scheduled sessions.

Child and Youth Care Practitioners Contributions to Evidence-based Practice in Group Care

Child and Youth Care Practitioners Contributions to Evidence-based Practice in Group Care

Chinese reluctance to report crime: Political efficacy, group care and hukou

Rising crime rates and strained police–community relations in China are calling for more research on people’s crime-reporting desires and associated predictors. Drawing upon survey data collected from a sample of 757 local and nonlocal residents in a large city in Southern China, this study takes the initiative to assess Chinese people’s reluctance to report crime to the police. Results show that a lower level of political efficacy, external efficacy specifically, is associated with a higher level of reluctance to report crime. The effects of group care are mixed, with the inner-circle care exerting a negative and the outer-circle care a positive association with crime-reporting desires. Furthermore, net of all controls, local hukou residents express lower levels of willingness than their nonlocal counterparts to report crime. Finally, the perception of police misconduct is the most significant and strongest predictor of Chinese people’s reluctance to report crime. These findings suggest the importance of including a combination of both policing and non-policing factors when studying crime-reporting inclination, opening up an interdisciplinary perspective for studying the issue.

The Combined Burden of Hearing Loss and Cognitive Impairment in a Group Care Setting for Older Adults

Purpose The purpose of the current study is to better characterize the medical and social health characteristics of older adults in a long-term group care setting and consider the impact of the dual burden of hearing loss and cognitive impairment. Method This descriptive analysis of a convenience sample of 160 adults ( M age = 74 years, age range: 59.8–99.7) participating in Program for All-inclusive Care for the Elderly programs in Massachusetts and Rhode Island included data from hearing testing, questionnaires, and medical chart review. Using descriptive statistics, groups are compared across a range of demographic and health variables on the categorical bases of hearing loss and cognitive status. Results Results suggest that hearing loss and cognitive impairment are highly prevalent among this sample of older adults. Forty-three percent of this sample has at least a mild hearing loss in the better hearing ear in addition to cognitive impairment. Descriptive analyses across demographic and health variables suggest there are few differences between those with and without cognitive impairment when compared within degree of hearing loss categories in this convenience sample. Across all participants, there was a high prevalence of other chronic conditions, most notably diabetes (59%), hypertension (90%), cardiovascular disease (80%), and depression (67%). Conclusions In this sample, there were not significant differences on demographic and health variables between the cognitive impairment groups when considered within their degree of hearing loss; however, the prevalence of the dual burden of hearing loss and cognitive impairment in this sample is high. Clinicians serving older adults, especially those accessing group care services, should be cognizant of the high burden of multiple chronic conditions and plan care that can be integrated into a comprehensive approach.